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This is the first of a second series of posts dealing with remission strategies from infections. The contents will apply regardless of which infection model you believe causes Chronic Fatigue Syndrome. The usual models are:

Bacteria are adapting continuously in order to survive. In this blog I’ll describe some of the tricks they use to evade the immune system. Whether you try antivirals, prescription antibiotics, herbs, or probiotics, unfortunately these tricks often allow the bacteria to survive. In subsequent posts I will describe methods that can be used to outsmart these bugs.

Evasion by Mutation

Some pathogens evolve very rapidly once they get inside the body, either by random mutation or probably more commonly by borrowing RNA fragments from other pathogens.

If they reproduce quickly (within a day or two) slight variations of the original infection may have been produced. Because anti-infectious agents often work by attaching to a section of the bug, if the shape of the pathogen has changed they may no longer be able to attach to it. Think of an antibiotic as a key and a section of the pathogen as a lock the key fits into; if the key is bent or a small part of it is filed down or if there is sand in the lock, the key will no longer work in the lock. This “shape-shifting” is the best known way for antibiotic resistance to occur.

A Few Mutations Away From a Deadly Bird Flu

Under The Dome

Another method of resistance used by organisms on the defense all over the world is to cluster together to expose as little surface area to attack as possible. Pathogens, like many other living things, can cluster together forming colonies (or even cities :)) in the body. When pathogens clump together the anti-infectious agent will only be able to kill off the outer edge of the colony. In other cases, the infections produce a kind of glue that catches whatever is floating by creating a wall of flotsam and jetsam.

Watch fire ants build a different kind of colony that is able float on the water in the video below.

Fire Ant Colony Able to Float on Water

In both cases, we end up with something like a domed city. The dome keeps the infection inside, mostly isolated from what’s outside, but allows enough small openings that it can grab the resources (food) it needs to survive and through which it can dump its toxins. A biofilm may further prevent antibiotics from reaching a bacterial infection.

The Rip van Winkle Approach: Resistance by Hibernation

Infections often have a complex life cycle, one stage of which is hibernation. A segment of the pathogen population can turn themselves off so thoroughly that anti-infection agents don’t recognize them. This kind of resistance generally applies to just 0.01-2% of a pathogen population.

If the immune system is weak and the pathogen has a good food supply, even if the non-hibernating bugs are wiped out, once the hibernating bugs wake up they can rapidly restore the infection.

Gut Manipulation

Results of recent advances in DNA analysis suggest infections and medical conditions may often produce a distinctive bacterial signature in the gut (the microbiome). Researchers have been able to determine the type of infection in some cases by analyzing the gut flora. In addition, pathogens can trigger the gut flora to produce factors the pathogen needs to reproduce, and to stop producing factors that assist the immune response.

This suggests that gut flora manipulation may be an important tool in assisting the immune response to fight off pathogens.

Exploiting the Body’s Means of Dealing with Infections

Establishing the beachhead

The human body has a variety of tricks to deal with infections. The core concept is to contain the infection until the immune system is able to manufacture the cells in needs to eliminate it.

Think of an infection as an invader establishing a beachhead in the body. The body will to do everything that it can to prevent the invader moving further in: it will destroy bridges, fell trees across roads, etc. In terms of our biology these mechanisms include:

While these tricks slow the infection moving into the body, they can also be exploited by the infection to subvert the immune response.

Resistance by Inflammation

Some pathogens are adept at turning the defenses the body throws up against them to their advantage. One purpose of inflammation is to prevent the spread of an infection until the immune system can be mobilized to address it, but these same measures that block the spread of an infection can also interfere with immune factors or antibiotics reaching the infection.

Resistance by Fibrin

Vasoconstriction can block immune agents from getting at a pathogne

Inert material called fibrin forms meshes over pathogens in order to slow the spread of an infection, but that mesh also inhibits the immune agent’s ability to get at the infection. A precursor to fibrin called soluble fibrin monomer allows the body to quickly create fibrin when needed. If this occurs in some people with ME/CFS – as some research suggests it might – they could end up with thick blood, misshapen red blood cells, and a difficult to reach infection.

Vascular constriction is another defense mechanism that infections can turn around and use to prevent immune agents from reaching them. Blood vessels that are overly constricted may admit only the essential foods that the infection needs and let the toxins it produces get out.

Conclusion

If the infection exploits enough of the options listed above it can become deeply established in the body. Getting rid of it may require systematically negating the pathogens tricks. In upcoming posts I will supply a simple cookbook recipe I’ve used to deal each item on this list to reduce infections.

great information on a symptom I’ve had particular difficulty with.
Hyperthermia treatments have assisted in ‘waking up’ my immune system and I am now fighting off the evil invading critters

Brent

Mar 26 - 5:21 pm

How can you prove infection? ME researchers haven’t been able to do so. Treating assumed infections with untested substances sounds neither effective nor safe.

Cort Johnson

Mar 28 - 11:01 am

I think there’s significant empirical evidence that infection is involved at least in a subset of patients. Dr. Peterson has reported on a retrospective Vistide study that found it significantly helped a subset of this patients and Dr. Peterson, Dr. Montoya and Dr. Lerner all use antivirals in some patients with success.

The Lipkin study did not find pathogens but several herpesvirus experts think his assay was not sensitive to find the kind of infection present in ME/CFS.

I suspect that Ken is probably also going natural means to improve immune functioning as well.

If you assume that CFS is caused by one infection alone — no way. That approach has been tried for decades with no luck. The model that I use is a post-infection persistent dysfunction gut bacteria — big words… In short, while you were sick (the pre-CFS flu), the infection changed your gut bacteria. The gut bacteria changes caused many of the symptoms.

After you got rid of the infection, the gut bacteria did NOT return to normal. Instead, it took a “sick” life of its own, keeping the symptoms going – chronically!

I went to uBiome site and I thought it said it takes several months to get results. That seems too long. I’ll check the other site. The price is right, at least.

I appreciate the three part series you did last year on normalizing gut bacteria, and have been thinking a lot about it. Looking back now, I think all my problems probably started in my gut. I think it was stress and food allergies that probably disordered the gut ecology, and then maybe an infection on top knocked me down. Or maybe infection came first and led to disordered gut.

How reliable do you think these DNA tests are? One would really like to be able to put the right targets in the crosshairs.

I believe they are at least 99% accurate. The testing is done in commercial labs with the state of the art machines (which is why they can do it so cheaply!).

My wife has Crohn’s and have made great improvement (but no remission yet) from the herbs/probiotic route. She is doing tests from both to get as much information as possible (when the results are received – I will post a detail comparison about what is reported by each.

It will give key information as to what the target is — the problem is getting the right bullets to hit the target. If you are in the US close to the Canadian border — you have the greatest choice of ammo available. The US is pretty unregulated for probiotics, and those that are regulated (Mutaflor E.Coli Nissle 1917) can be purchased in Canada.

For the overgrowth, we have to walk a slightly complex mine field. We want to kill off the overgrowth WITHOUT making the undergrowth worst. Slugging thru PubMed, I ended up with some “higher probability of being the right profile” herbs – Tulsi and Neem. If E.Coli overgrowth (or as a pre-Mutaflor purge) Haritaki.

In the US, we are a very free enterprise country — thus if folks like Swanson gets saturated with requests for probiotics that contain ABC, they may actually produce it….

So, I believe that this is likely the best path forward. Not an easy path — but a viable path.

issie

Mar 26 - 6:35 pm

Loved this!

I feel autoimmune and inflammation are our two main problems. Addressing those with diet first and then assister supplements and/or antibiotic and antimalarial products along with enzymes to break down biofilms may be our solutions. And then probiotics to balance out flora and gut ecology.

Looking forward to your follow up blogs on this.

Issie

Gina

Mar 27 - 9:03 pm

Issie! I totally agree… I have always felt like inflammation & autoimmune are our two problems too!

Curious, what enzymes are you taking to break down the biofilms?

Great article Cort! Thank you!

issie

Mar 28 - 12:17 am

I use lumbrokinase at least two hours before either my antibiotic (doxy) or antimalarial herbs. Then at least two hours later I use a good probiotic.

I feel this along with a lowfat, whole food, vegan diet (which also address the immune system and inflammation) has been my best protocol to date. I’ve been doing this for about a year now with real good results. (Vegans use no animal products.)

I use some other supplements too. I found turmeric to be very essential for me.

Since I have a CBS mutation and issues with sulphur, I’ve been afraid to try ALA. I have a bottle, just havent been brave enough to attempt it.

I purchase bulk turmeric too, from the spice isle. Put it in my own caps.

I also have to use some pretty high doses of Vit D3. I saw that listed on your site.

Some of the things you talk about, go along with MCAS (Mast Cell Actvation Syndrome). Have you looked into that? This is something else I have and treat. It’s one thing that I must address and not ignore.

On the surface, MCAS (Mast Cell Actvation Syndrome) and Histamine intolerance appear to be the same. Mast Cells are what dump histamine into the body.

I believe that a subset of CFSer has this issue complicating their treatment. A good example is Evening Primrose Oil — it and ALA are very similar in effect. EPO is poorly handled by some CFSer — since it is also rich in salicylates and ALA is not — the reason may be because of salicylates causing histamine release (speculation).

While I seem not to be either salicylates or histamine sensitive, I know enough CFSers that are one or the other, and recently started to drill into this area because of one of them. This issue appears to fit well into my existing model of what causes CFS (which allows treatment options to be research better — i.e. we want not just anticoagulants, but anticoagulant that do not provoke histamine release…)

issie

Mar 28 - 4:33 pm

Surprisingly, some MCAS docs are having some use low dose aspirin to cause a slow mast cell degranulation which does release histamine. This works for some, but not others. (I can’t do it.) The idea is to create a slow release to avoid a big dump, possibly causing anaphylaxis.

I have found that quercetin helps with not only the mast cell issues, but also thins the blood and helps with inflammation.

Issie

Mike Dessin

Mar 28 - 10:11 am

Wonderful article Ken..We get the best info here on Health Rising!

Do have to disagree on the tumeric and some of the other supplements such as ALA listed on the CFS wordpress.com.

This is a disease of phases…not one supplement fits all, treatment should vary depending on what phase of the disease your in..tumeric and ALA are also very strong chelaters as well and can cause very strong detox symptoms if you have been sick a long while.

Cheers!

marcie myers

Mar 28 - 6:40 pm

I can only glance at this article because if microbes aerobic or anaerobe or fungi or whatever critter were the culprit in whichever model…….why do I NEVER read about the complete turnaround from illness to their previously clear-minded, energetic, healthy state? Why does no one who has had this anywhere beyond the originations ever get ALL well? If you are out there, please tell me the secret. Please.

I am back to my old self, doing a highly demanding cognitive job (Principal Software Engineer) in a stressful environment (a startup, pre-IPO). I do monitor for early indicators of problems and keep pro-active in good maintenance of my gut flora (which means very little lactobacillus, but other probiotics such as E.Coli Nissle 1917 and Prescript Assist).

As always thanks for your insights. A few questions related to your condition. Do you or did you have PEM? Also, how is your sleep? These are 2 areas which have always been an issue for me. Also, do you have any self-imposed dietary restrictions, alcohol, wheat, dairy, etc?
I look forward to your next email as I am planning on implementing a new plan to fight off pathogens in multiple areas. My current doctor has a plan for treating sinus issues, but I want to treat the gut too. However, none of my doctors will prescribe me minocylcine, so I am curious as to your naturopathic plan. Also, I might finally have a lead on how to get some Mutaflor, but I am sure overnight shipping from Toronto is going to be ridiculous.

Yes, I *had* PEM as well as mild MCS (there is still one chemical that will set if off, but no problems around perfumes etc *now*). Sleep is now good, solid 8 hr and wake up bright alert and rested.

My Naturopath was in a chronic lyme practice (with Dr. Marty Ross in Seattle) and the need for antibiotics was accepted. I asked for minocycline as the first choice because it is a NEUROPROTECTOR with over 300 articles on PubMed stating that. So the reason to prescribe was NOT as an antibiotic but as a neuroprotector for someone clearly having cognitive issues (in my case, a SPECT scan that the radiologist read as Alzheimer’s Disease, helped justified it).

Great article, Ken. I would like to have a list of your articles dealing with gut microbiota to help manage Crohn’s/UC. My followers, at “Living with Crohn’s & Colitis: A Comprehensive Naturopathic Guide for Complete Digestive Wellness,” will really benefit from your research! Cort’s site is really terrific, and helps someone like me, too (I have Crohn’s).

Ken, did I read that your wife has Crohn’s? Maybe I could cross-post some of your articles? I am on a strict diet of no dairy, no grains, no sugar. Supplements include probiotics and turmeric. I am really healthy and haven’t had symptoms for almost eight years (I did have a partial bowel resection, in 2006, that changed my life and set me in a path toward wellness— that is when I wrote my book because I was disillusioned by the recommendations of my GI doctors who said I should take heavy-duty, autoimmune-suppressing drugs!

She tried a few of those drugs and had severe neurological effect (including from an antibiotic sometimes used for CFS). Since has been doing the herb/probiotic route and every MRI (including this weeks) has shown improvement.

Feel free to repost.

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